Back Pain Secondary Gain Theory

Back pain secondary gain is related to true
psychosomatic back pain,
but differs in several crucial areas. Secondary gain describes external
psychological motivating factors for the initiation or perpetuation of
painful symptoms. The patient may or may not be consciously aware of
these psychoemotional motivations, but they exist nonetheless.

Secondary gain is a common
misdiagnosis
for patients with true psychosomatic pain generated from internal emotional issues which have been repressed.

In my own experience working as a trial preparation investigator
in New York City, I saw many blatant instances of secondary gain
demonstrated by plaintiffs in civil personal injury lawsuits. In some
cases, the plaintiff was obviously aware that there was gain to be had
from their pain, but in others, the person seemed completely oblivious
to the fact that their pain was likely inherently related to their
present course of litigation and treatment with a doctor who was a
puppet under control of their lawyer.

This essay explores the controversial topic of secondary gain often associated with chronic pain patients.

Back Pain Secondary Gain vs. Primary Gain

Primary gain
is the actual reason for most
psychosomatic pain syndromes to exist.
Usually, the primary gain of the symptoms is to cover up unresolved,
sensitive and deeply repressed issues within the patient’s subconscious
mind. Basically, the pain serves to distract from these repressed emotions, since
it is in their nature to strive for conscious recognition.

The subconscious mind fears the release of these repressed
emotions and the havoc they may cause in the patient’s consciousness.
It is for this reason that the subconscious institutes any of the
overwhelming number of psychologically-induced pain syndromes which have
become such an
epidemic
in our healthcare system today.

Back Pain Secondary Gain Motivations

Secondary gain, unlike primary gain, is symptomatic motivation which
affects the patient’s external environment. Rather than protect the
patient from internal stressors, secondary gain protects the patient
from factors relating to work, interpersonal relationships, finance,
responsibilities and any other factors having to do with how the patient
interacts with the outside world.

True secondary gain is not consciously caused by the patient in
an attempt to benefit from the pain. The patient may or may not realize
the benefits of secondary gain, but they do not consciously cause it to
be. This is not the same phenomenon as a patient who pretends to be
sick or exaggerates a condition on purpose, in order to gain a
particular objective. Instead, the recognition of benefit from pain is
subconscious and driven without the patient’s conscious control.

Back Pain Secondary Gain Experiences

Some patients have been told that their pain might have something to
do with psychological factors. Unfortunately, most of these patients
have been written off by doctors as having a primary physical pain
syndrome and a secondary psychological gain perpetuating factor. This
is rarely the actual situation for most patients with psychosomatic pain
syndromes.

A great number of patients with
chronic back pain
are actually suffering from psychosomatic primary gain as the one and only
source of their physical symptoms. Medical science does not recognize
primary gain as the cause of most back ache conditions, which accounts
for its dismal treatment statistics.

Accepting the role of the mind in
the enactment of physical symptoms is the first and most difficult step
for patients to accomplish. However, this realization is vital if they
are to be permanently free from their tormenting pain conditions.

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